Semifluorinated alkane compositions

ABSTRACT

The invention provides novel compositions comprising semifluorinated alkanes and at least one compound sensitive or prone to oxidation. The compositions can be used as medicines that are topically administered to an eye or ophthalmic tissue. The invention further provides kits comprising such compositions.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/427,969, filed on Mar. 12, 2015, which application is a NationalStage Entry under 35 U.S.C. § 371 of International Application No.PCT/EP2013/068909, filed Sep. 12, 2013, which claims priority toEuropean Patent Application No. 12183997.1, filed Sep. 12, 2012, andEuropean Patent Application No. 13169399.6, filed May 27, 2013, thecontents of each of which are incorporated herein by reference.

FIELD

The present invention is in the field of compositions comprisingoxidation-prone pharmaceutically active ingredients, specificallycompositions that are based on semifluorinated alkanes. In particular,the compositions of the present invention may be topical ophthalmiccompositions useful in the treatment of ocular diseases or conditions.

BACKGROUND

The stability of an active pharmaceutical compound during storage over avariety of conditions is a generally of concern during development of aformulation for the compound. This aspect is especially relevant forliquid formulations of compounds which are sensitive and/or prone todecomposition via oxidation pathways. It is becoming even more relevanttoday as countries with hot and moderately humid climate (i.e. ICH zoneIVb countries) are becoming increasingly important to pharmaceuticalcompanies so that new drug formulations are needed which take intoaccount the higher temperatures and humidifies of these countries.

Oxidation may be promoted thermally, photolytically, or by chemicalmeans. Compounds comprising aliphatic double bond systems are, inparticular, sensitive towards degradation by oxidation, often viafree-radical chain processes with molecular oxygen.

Such processes, known also as auto-oxidation, generally begins via aninitiation process in which a free-radical is generated (e.g. viaabstraction of a hydrogen atom by an initiator radical), followed bypropagation steps involving oxygen and further compound molecules.Termination may occur when two radical products couple. Compoundscomprising free-radical stabilizing aliphatic double bond configurationssuch as the methylene-interrupted polyene systems of polyunsaturatedlipid derivatives are generally more susceptible to auto-oxidation.These and other oxidation processes can readily lead to, over time, theformation and accumulation of undesirable and pharmaceuticallyineffective reaction products. Some of the degradants may be harmful ortoxic.

The use of antioxidants and/or stabilizer excipients remains one of theforemost strategies for mitigating or preventing the oxidation of suchcompounds and to increase shelf-life. Typical antioxidants are butylatedhydroxytoluene (BHT), ascorbic acid, tocopherol derivatives etc. Manyantioxidants will act as free-radical scavengers; and act by terminatingfree-radicals and inhibiting the chain processes. Excipients which canact as metal ion chelators e.g. ethylene diamine tetraacetic acid (EDTA)may also be used to limit the effect of trace heavy metal impuritieswhich can also catalyse oxidation reactions. The encapsulation orshielding of oxidation-sensitive compounds, such as with liposomes orcyclodextrins are also known methods of preventing degradation.

A further measure to prevent oxidative degradation of such compoundswould be the removal of oxygen dissolved in the liquid vehicle throughsparging with an inert gas, with for example, nitrogen. This is howeverprocess-intensive and not cost-effective, and requires, in addition,special attention during further processing steps and with packaging toprevent the reintroduction of atmosphere.

Polyunsaturated fatty acids (often abbreviated as PUFA) are a class ofcompounds that are prone to oxidative degradation. These include omegafatty acids such as omega-3 fatty acids (also known as (ω-3 fatty acidsor n-3 fatty acids) and omega-6 fatty acids (also known as (ω-6 fattyacids or n-6 fatty acids). These are essential fatty acids because theyare available only through dietary intake, and because they involved inmany human metabolic processes and functions. As such, they have beenimplicated as beneficial in the treatment or prophylaxis of a widevariety of different health conditions.

For example, these compounds have been found to be useful for thetopical treatment and prevention of ocular pathologies such as dry eyedisease (DED). DED, also known as keratoconjunctivitis sicca ordysfunctional tear syndrome, is a multifunctional disorder of the tearfilm and ocular surface which results in discomfort, visual disturbance,and often even in ocular surface damage. The loss in dynamic stabilityof the structure, composition, volume and distribution, as well asclearance of the tear film can lead to the development of DED.

An inflammation cycle is one of the key processes that maintain andpotentially progress the dry eye condition. Omega fatty acids, inrelation to their anti-inflammatory properties, have been found toreduce the severity of DED and its symptoms and improve tear secretion.Omega-3 fatty acids, in particular, have been associated with themodulation of the production of anti-inflammatory and immunomodulatoryeicosanoid prostaglandins such as PGE1. They are also implicated insuppressing the expression of pro-inflammatory cytokines such as IL-1and TNF-α, which are associated with dry eye disease.

The formulation of such active ingredients prone to oxidation intotopical ophthalmic compositions such as eye drops can however bechallenging. The choices of excipients, and therefore antioxidants andstabilizers which can be used are more limited due to incompatibility,toxicity or poor tolerance with the ocular surface. At the same time,however, the minimization of degradation (resulting in colour changes ofthe preparation, precipitation of insoluble materials, etc.) becomesmore acute.

Compositions comprising omega fatty acids for the topical treatment ofthe dry eye condition and its symptoms are however known in the art.Gastrointestinal intolerance resulting from the oral ingestion of largequantities of these fatty acids as supplements (and systemic absorptioneffect) can be avoided with direct and local administration of theseactive molecules to the surface of the eye.

For example, Remogen® Omega (marketed by TRB Chemedica InternationalS.A.), is a commercially available ophthalmic preparation comprisingomega fatty acids that indicated for dry eye conditions. As disclosed inits product information, the preparation is a hypotonic hydrogelcontaining eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA),antioxidant vitamin E (tocopheryl acetate), the emollient substancescarbopol 980, glycerol, pemulen, and sodium hydroxide, disodiumphosphate, and distilled water. The hydrogel composition itself isdescribed as a microemulsion, with a dispersion of the lipidic molecules(fatty acids and vitamin E). The product is packaged in the form ofsingle-dose containers packed in an aluminium pouch, with therecommendation to discard the product immediately after use. Withrespect to stability, storage is suggested to be in a refrigerator at2-8° C., with a shelf-life of 3 months if stored, at below 25° C.,unrefrigerated. Due to its poor thermal stability, the product isshipped in a cold chain, i.e. transported in refrigerated containers andstored at the warehouse and in the pharmacy under refrigeration. Thusthe consignment is expensive and requires a substantial effort in termsof temperature monitoring and logistics.

Similar, if not the same type of ophthalmic hydrogel compositions arealso disclosed in U.S. 2012/0010280. It is described that the fattyacids are in solution in the antioxidant tocopheryl acetate, with thetocopheryl acetate present in amounts of up to 75% by weight of the oilymixture. These are dispersed as oily droplets in the hydrogel. Aqueousemulsions comprising a combination of omega-3 and omega-6 fatty acids,and surfactant (e.g. Tween 80), Glucam E-20, and a drop of vitamin E asan antioxidant were found to be poorly adapted for maintaining stabilityof the omega fatty acids are proposed in WO 2006/007510. It should benoted, however, that emulsion systems based on hydrogels, with theirgenerally increased viscosity and bioadhesive properties may incur, uponinstillation and also during its contact time to the ocular surface,irritating foreign body sensation and blurred vision. Depending also onthe degree of their viscosity, these may be more difficult to dispenseand administer.

In general, one of the major disadvantages of formulations based onemulsions system is that in contrast to single phase systems, emulsionsystems may be more complex and difficult to manufacture, especially insterile form. Frequently, they are not readily sterilisable by thermaltreatment without negative impact on their physical properties.Emulsions are also inherently unstable, and could phase separate withtime or fluctuations in storage conditions. They, as with all aqueousbased systems, are more prone to microbial contamination during use aswell. The aseptic processing of emulsions is complex, costly, and isassociated with higher risks of failure, i.e. microbial contamination.

Retinoid (Vitamin A) derivatives are another class of hydrocarboncompounds comprising high levels of polyunsaturation, and which are alsoprone to degradation via oxidation pathways. Retinoid derivativesinclude retinol, retinal, retinoic acid, tretinoin, isotretinoin,alitretinoin, and related derivatives. Vitamin A derivatives have beenused for the treatment of inflammation in relation to the cornea,conjunctiva and other mucosal and epithelial tissues, includingconditions such as dry eye disease.

U.S. 2012/0095097 for example discloses aqueous ophthalmic compositionscomprising Vitamin A, at least 0.4 w/v % of polyoxyethylenepolypropylene glycol and trometamol. Antioxidants such asdibutylhydroxytoluene and α-tocopherol acetate, may also be present inthese compositions. These compositions are based on micelles of VitaminA, which is presumably shielded and stabilized by non-ionic surfactantpolyoxyethylene polypropylene glycol. These compositions are notpreserved as such.

In principle, these preparations would require, if they were to bepresented in multi-dose containers which are in principle morecost-efficient and convenient for patients than single-use vials,preservation in order to ensure their microbiological quality. The samewould be applicable to all aqueous-based preparations. At the same timehowever, preservatives which can be used in ophthalmic formulations arepotentially damaging to the eye, in particular to the ocular surface,and should be avoided especially in the context of dry eye disease. Atleast in earlier years, multi-dose formulations for ophthalmicadministration had to be preserved using a physiologically acceptablepreservative in order to reduce the risk of microbial contamination andinfection.

Most preservatives are however problematic for DED patients in that theyhave a potential to negatively affect the ocular surface, thuscounteracting the therapeutic intent. This is particularly relevant forpatients with moderate to severe dry eye disease symptoms who mayrequire frequent use for symptom relief, as well as patients who requiremultiple preserved topical medicaments.

As an alternative, single-dose containers are the main option for theadministration of non-preserved formulations such as those used for theRemogen® Omega product. These are however less cost-efficient andconvenient to handle for the patient than the conventional multi-dosebottle. Whilst ophthalmic formulations utilizing ‘vanishing’preservatives such as sodium chlorite or sodium perborate, which canconvert to non-toxic ions and water after instillation and contact withthe tear film may also be an option, these may still be irritating topatients especially those with severe disease who may not havesufficient tear volume to effectively degrade the preservatives.

WO 2011/073134 discloses ophthalmic topical pharmaceutical compositionscomprising immunosuppressant macrolides such as ciclosporin A andsemifluorinated alkanes, for treatment of keratoconjunctivitis sicca.The semifluorinated alkanes in the disclosed compositions serve assuitable liquid vehicles for delivering the therapeutic pharmaceuticalagent to the eye, and in particular have a high capacity for dissolvingextremely challenging poorly soluble compounds such as ciclosporin.However, there is no mention of the ability of semifluorinated alkanesto stabilize oxidation-sensitive compounds over an extended period oftime.

It is therefore an object of the present invention to provide a novelcomposition which comprising one or more active compounds comprisingmore than one aliphatic double prone to oxidation, and which at the sametime addresses and overcomes the various issues and at least one of thelimitations or disadvantages associated with prior art formulations. Ina specific aspect, it is an object of the invention to provide anophthalmic composition for the treatment or prevention of a condition ordisease such as dry eye or conditions relating to the inflammation ofthe ocular tissue. In a further aspect, it is an object of the inventionto provide a method of stabilizing an active compound with more than onealiphatic double bond prone to oxidation which does not exhibit one ormore of the disadvantages of prior art. Further objects of the inventionwill become clear on the basis of the following description, examples,and patent claims.

SUMMARY OF THE INVENTION

In a first aspect, the present invention provides a stable liquidcomposition comprising an active compound with more than one aliphaticdouble bond prone to oxidation, wherein the active compound isdissolved, dispersed or suspended in a liquid vehicle comprising asemifluorinated alkane of formula F(CF₂)_(n)(CH₂)_(m)H or of formulaF(CF₂)_(n)(CH₂)_(m)(CF₂)_(o)F, wherein n, m, and o are integersindependently selected from the range of 3 to 20. The liquid vehicle issubstantially free of water.

In one of the embodiments, the composition of the invention comprises apolyunsaturated fatty acid or derivative thereof, in particular an esterderivative. It is further preferred that the polyunsaturated fatty acidor derivative is selected from an omega-3 or omega-6 fatty acid orderivative, such as an omega-3 or omega-6 fatty acid ester, or a mixturethereof. In a further preferred embodiment, said omega-3 or omega-6fatty acids are selected from docosahexaenoic acid or eicosapentaenoicacid and ester derivatives thereof.

In a further aspect, the invention provides the use of such compositionsas a medicament, wherein the medicament may be topically administered tothe eye or ophthalmic tissue, and/or wherein the medicament may be usedfor the treatment of a condition or disease of an eye or ophthalmictissue such as inflammatory conditions of the ophthalmic tissue orkeratoconjunctivitis sicca (dry eye).

In yet a further aspect, the invention provides a method of stabilizingan active compound with more than one aliphatic double bond prone tooxidation comprising the step of dissolving, dispersing, suspending theactive compound in a liquid vehicle comprising a semifluorinated alkaneof formula F(CF₂)_(n)(CH₂)_(m)H or of formulaF(CF₂)_(n)(CH₂)_(m)(CF₂)_(o)F, wherein n, m, and o are integersindependently selected from the range of 3 to 20, and wherein the liquidvehicle is substantially free of water. In one of the preferredembodiments, the active compound is an omega-3 or an omega-6 fatty acidor an ester derivative thereof.

DETAILED DESCRIPTION OF THE INVENTION

In a first aspect, the invention provides a stable liquid compositioncomprising an active compound with more than one aliphatic double bondprone to oxidation. The composition is further characterized in that theactive compound is dissolved, dispersed or suspended in a liquid vehiclecomprising a semifluorinated alkane as defined in claim 1 and furtherexplained below

As used herein, an active compound refers to any type ofpharmaceutically, nutraceutically or otherwise health-promoting activecompound or derivative that is useful in the prevention, diagnosis,stabilization, treatment, or—generally speaking—management of acondition or disease. A therapeutically effective amount refers to adose, concentration or strength which is useful for producing a desiredpharmacological, nutraceutical or otherwise health-promotingor—supporting effect.

Active compounds with more than one aliphatic double bond prone tooxidation are usually susceptible to degradation and deterioration overtime and storage. The aliphatic double bonds of these compounds arefeatured in configurations that are particularly prone to undergooxidation reactions, leading to the formation of side products andquantitative loss of active compound over time. The present inventionprovides methods of stabilizing such active compounds against oxidation,in particular oxidation which may occur and/or be promoted by thermal,photolytic or chemical means, and in the presence of oxygen as may bepresent in the atmosphere or as introduced to an initially inertenvironment over time.

As used herein, an aliphatic double bond refers to a carbon-carbondouble bond (C═C). An active compound with more than one such doublebond may have at least two aliphatic double bonds, in particular in aconfiguration wherein the double bonds are separated by a methylenegroup (—CH₂—). The one or more aliphatic double bonds of the activecompounds of the invention may be in the cis (Z) or trans (E)configuration, or combinations thereof. In one embodiment, the activecompound of the invention comprises a structural component of theformula —(HC═CH—CH₂—HC═CH)_(x)—, wherein x is an integer ranging from 2to 10, in particular from 2 to 5.

Active compounds with more than one aliphatic double bond in which thedouble bonds are separated by a bridging methylene group (also commonlyreferred to as compounds possessing methylene-interrupted polyenes)include polyunsaturated fatty acids. Polyunsaturated fatty acids arelinear carboxylic acids possessing carbon chains with more than onecarbon-carbon double bond. These lipophilic lipids are prone tooxidation, especially in the presence of atmospheric oxygen via radicalinitiated auto-oxidation processes. In an embodiment, the compositionsof the invention comprise a polyunsaturated fatty acid with number ofcarbon atoms ranging from C16 to C24. Derivatives of polyunsaturatedfatty acids, such as esters and in particular alkyl esters are withinthe scope of the invention. It should be understood within the contextof the present invention that a reference to any polyunsaturated fattyacid, or group or species thereof, also covers the respectivederivatives, in particular the esters, even if not specificallymentioned.

Polyunsaturated fatty acids (often abbreviated as PUFA) include omegafatty acids such as omega-3 fatty acids (also known as ω-3 fatty acidsor n-3 fatty acids) and omega-6 fatty acids (also known as ω-6 fattyacids or n-6 fatty acids). Examples of omega-3 fatty acids (also knownas ω-3 fatty acids or n-3 fatty acids) include eicosapentaenoic acid(EPA), docosahexaenoic acid (DHA), α-linolenic acid (ALA). Examples ofomega-6 fatty acids (also known as ω-6 fatty acids or n-6 fatty acids)include gamma-linolenic acid, linoleic acid, dihomo-gamma-linolenicacid. Derivatives of omega-3 fatty acids or omega-6 fatty acids, such asester or alkyl ester derivatives are also within the scope of theinvention. Particularly preferred alkyl ester derivatives areeicosapentaenoic acid ethyl ester or docasahexaenoic acid ethyl ester.Derivatives of eicosapentaenoic acid or docosahexaenoic acid such asresolvins and neuroprotectins are also suitable as active compoundswithin the scope of the invention.

In a further embodiment, the active compounds with more than onealiphatic double bond prone to oxidation are compounds comprising astructural component with more than one aliphatic double bond in linearconjugation with one another. Active compounds comprising more than onealiphatic double bond in linear conjugation are also commonly referredto as polyenes. Preferably, the active compound comprises at leastthree, or more preferably four or five linearly conjugated double bondsPreferably, the active compounds structurally comprise a conjugatedtriene, tetraene, pentaene, hexaene or heptaene component. In oneembodiment, the active compound comprising a polyene component may be amacrocycle, wherein the polyene or the linearly conjugated double bondsform part of the cyclic structure. The one or more linearly conjugatedaliphatic double bonds may be in the cis (Z) or trans (E) configuration,or combinations thereof.

Examples of active compounds comprising more than one linearlyconjugated double bond include, but are not limited to, lipophilicvitamin derivatives such as retinoids and derivatives thereof. Thisclass of compounds are also unstable towards prolonged storage and proneto degradation through oxidative pathways such as auto-oxidation.Retinoids and retinoid derivatives (also often referred to as Vitamin Aderivatives) include retinol, retinoic acid and its esters (e.g. retinolpalmitate or retinol acetate), retinal, tretinoin, isotretinoin, andalitretinoin.

Further examples of active compounds also comprising linearly conjugateddouble bond systems sensitive and or prone to radical-mediated oxidativedegradation with oxygen include sirolimus (rapamycin), a macrolideimmunosuppressant drug compound whose structure contains threecontiguous double bonds.

Moreover, polyene compounds are contemplated as oxidation-sensitiveactive ingredients according to the invention, in particular polyeneantifungals. In one embodiment, the composition comprises a polyeneantifungal such as nystatin, natamycin or amphothericin dissolved in aliquid carrier substantially consisting of one or more semifluorinatedalkanes as described herein.

The compositions of the invention may optionally further comprise acarotenoid or carotenoid derivative, in particular a xanthophyll. Thesecompounds also possess poly-conjugated double bond systems. Particularlypreferred are lutein and zeaxanthin. Derivatives of lutein orzeaxanthin, such as lutein or zeaxanthin esters are also considered. Ina particular embodiment, liquid compositions comprising at least two ormore semifluorinated alkanes further comprise lutein or a derivativethereof.

In a further embodiment, the composition comprises ciclopirox olamine asactive ingredient. Preferably, ciclopirox olamine is incorporated in thedissolved state. As will be discussed in more detail below, some of thekey advantages of the present invention are brought about by thepresence of a semifluorinated alkane in the composition as liquidvehicle, or part of the liquid vehicle, for active compounds such aspolyunsaturated fatty acids, retinoids, or other active compounds withmore than one aliphatic double bond prone to oxidation.

Semifluorinated alkanes are linear or branched alkanes some of whosehydrogen atoms have been replaced by fluorine. In a preferredembodiment, the semifluorinated alkanes (SFAs) used in the presentinvention are composed of at least one non-fluorinated hydrocarbonsegment and at least one perfluorinated hydrocarbon segment.Particularly useful are SFAs which have one non-fluorinated hydrocarbonsegment attached to one perfluorinated hydrocarbon segment, according tothe general formula F(CF₂)_(n)(CH₂)_(m)H, or two perfluorinatedhydrocarbon segments separated by one non-fluorinated hydrocarbonsegment, according to the general formula F(CF₂)_(n)(CH₂)_(m)(CF₂)_(o)F.

Another nomenclature which is used herein refers to the above-mentionedSFAs having two or three segments as RFRH and RFRHRF, respectively,wherein R_(F) designates a perfluorinated hydrocarbon segment, R_(H)designates a non-fluorinated segment. Alternatively, the compounds maybe referred to as FnHm and FnHmFo, respectively, wherein F means aperfluorinated hydrocarbon segment, H means a non-fluorinated segment,and n, m and o is the number of carbon atoms of the respective segment.For example, F3H3 is used for perfluoropropylpropane. Moreover, thistype of nomenclature is usually used for compounds having linearsegments. Therefore, unless otherwise indicated, it should be assumedthat F3H3 means 1-perfluoropropylpropane, rather than2-perfluoropropylpropane, 1-perfluoroisopropylpropane or2-perfluoroisopropylpropane.

Preferably, the semifluorinated alkanes according to the generalformulas F(CF₂)_(n)(CH₂)_(m)H and F(CF₂)_(n)(CH₂)_(m)(CF₂)_(o)F havesegment sizes ranging from 3 to 20 carbon atoms, i.e. n, m and o areintegers independently selected from the range of 3 to 20. SFAs whichare useful in the context of the present invention are also described inEP-A 965 334, EP-A 965329 and EP-A 2110126, the disclosure of whichdocuments is incorporated herein.

In a further embodiment, the compositions of the invention comprise asemifluorinated alkane according to the formula F(CF₂)_(n)(CH₂)_(m)H,wherein n and m are integers independently selected from the range of 3to 20. In another particular embodiment, n is an integer from the rangeof 3 to 8 and m is an integer from the range of 3 to 10. In yet anotherparticular embodiment, the semifluorinated alkane is a compoundaccording to the formula F(CF₂)_(n)(CH₂)_(m)H wherein n is an integerfrom the range of 6 to 20 and m is an integer from the range of 10 to20. Most preferably, the semifluorinated alkane is a liquid. PreferredSFAs include, in particular, the compounds F(CF₂)₄(CH₂)₅H,F(CF₂)₄(CH₂)₆H, F(CF₂)₄(CH₂)₈H, F(CF₂)₆(CH₂)₄H, F(CF₂)₆(CH₂)₆H,F(CF₂)₆(CH₂)₈H, and F(CF₂)₆(CH₂)₁₀H. Further preferred SFAs include, inparticular, F(CF₂)₈(CH₂)₁₀H and F(CF₂)₁₀(CH₂)₁₂H.

In a further embodiment, the composition may comprise more than one SFA.Preferably, compositions comprising more than one SFA comprise at leastone of SFAs selected from F(CF₂)₄(CH₂)₅H, F(CF₂)₄(CH₂)₆H,F(CF₂)₄(CH₂)₈H, F(CF₂)₆(CH₂)₄H, F(CF₂)₆(CH₂)₆H, F(CF₂)₆(CH₂)₈H, andF(CF₂)₆(CH₂)₁₀H. In another embodiment, the composition comprises atleast two SFAs selected compounds F(CF₂)₄(CH₂)₅H, F(CF₂)₄(CH₂)₆H,F(CF₂)₄(CH₂)₈H, F(CF₂)₆(CH₂)₄H, F(CF₂)₆(CH₂)₆H, F(CF₂)₆(CH₂)₈H, andF(CF₂)₆(CH₂)₁₀H, and at least one of F(CF₂)₈(CH₂)₁₀H andF(CF₂)₁₀(CH₂)₁₂H. In one of the preferred embodiments, the compositioncomprises a first semifluorinated alkane of formulaF(CF₂)_(n)(CH₂)_(m)H, wherein n is an integer from the range of 3 to 8and m is an integer from the range of 3 to 10 and a secondsemifluorinated alkane of the formula F(CF₂)_(n)(CH₂)_(m)H wherein n isan integer from the range of 6 to 20 and m is an integer from the rangeof 10 to 20.

As mentioned, the compositions comprise an active compound with morethan one aliphatic double prone to oxidation, wherein the activecompound is dissolved, dispersed or suspended in a liquid vehiclecomprising a SFA that is substantially free of water. In someembodiments, the liquid vehicle comprising a SFA may further compriseother organic liquids or other excipients, but is effectively free ofwater.

According to a particular embodiment, the active compounds of theinvention may be dissolved, that is, in complete solvation or solutionin a liquid vehicle comprising a semifluorinated alkane. Alternatively,the active compounds may be dispersed or suspended in a liquid vehiclecomprising a semifluorinated alkane. As used herein, dispersing meansthe formation of a system having at least one continuous (or coherent)phase and at least one discontinuous (or inner) phase which is dispersedin the continuous phase. The term dispersion is understood to includecolloidal systems in which the active compound is finely dispersed inthe liquid phase. It is also understood that a suspension is a type ofdispersion, in which the dispersed phase is in the solid state. Thesuspensions useful for practicing the invention are liquids, at least atphysiological temperature, which means that the continuous phase isliquid. Typically, suspensions are liquid at room temperature.

Liquid SFAs are chemically and physiologically inert, colourless andstable. Their typical densities range from 1.1 to 1.7 g/cm³, and theirsurface tension may be as low as 19 mN/m. SFAs of theF(CF₂)_(n)(CH₂)_(m)H type are insoluble in water but also somewhatamphiphilic, with increasing lipophilicity correlating with anincreasing size of the non-fluorinated segment. Liquid SFAs of this typeare being used commercially for unfolding and reapplying a retina, forlong-term tamponade as vitreous humor substitute (H. Meinert et al.,European Journal of Ophthalmology, Vol. 10(3), pp. 189-197, 2000), andas wash-out solutions for residual silicon oil after vitreo-retinalsurgery. This and other applications have established SFAs asphysiologically well tolerated compounds.

It has also been proposed that SFAs have high solubility for gases suchas oxygen, and may act as oxygen carriers (U.S. Pat. No. 6,262,126).Experimentally, they have been used as blood substitutes, asoxygen-carriers (H. Meinert et al., Biomaterials, Artificial Cells, andImmobilization Biotechnology, Vol. 21(5), pp. 583-95, 1993).

In contradiction to such facts and teachings, the inventors have foundthat liquid compositions comprising SFAs and the oxidation-sensitiveactive compounds, such as those described above, are surprisingly stableunder ambient as well as non-ideal conditions (as illustrated by theexamples further below).

The inventors have found that a method of stabilising a compound of theinvention can simply comprise the step of dissolving, dispersing, orsuspending an active compound of the invention in a liquid vehiclecomprising a semifluorinated alkane, as no additional antioxidants orother active compound stabilizers, as are typically used for theformulation of such compounds are required. This simplification can beadvantageous for various medical uses of the composition involvingespecially, frequent administration to tissues such as ocular or mucosaltissues. These generally have poor tolerability to a wide variety ofantioxidants and stabilizers and generally do not benefit from frequentexposure to such excipients.

In one embodiment, a method of stabilising a polyunsaturated fatty acidor an ester derivative thereof comprises the step of dissolving,dispersing or suspending the polyunsaturated fatty acid or an esterderivative thereof in a liquid vehicle comprising a semifluorinatedalkane of formula F(CF₂)_(n)(CH₂)_(m)H or of formulaF(CF₂)_(n)(CH₂)_(m)(CF₂)_(o)F, wherein n, m, and o are integersindependently selected from the range of 3 to 20 and wherein the liquidvehicle is substantially free of water. In yet a further embodiment,said method of stabilisation comprises the step of dissolving,dispersing, or suspending a polyunsaturated fatty acid selected from anomega-3 or an omega-6 fatty acid or ester derivatives, or mixturesthereof in a liquid vehicle comprising a semifluorinated alkane selectedfrom F(CF₂)₄(CH₂)₅H, F(CF₂)₄(CH₂)₆H, F(CF₂)₄(CH₂)₈H, F(CF₂)₆(CH₂)₄H,F(CF₂)₆(CH₂)₆H, F(CF₂)₆(CH₂)₈H, and F(CF₂)₆(CH₂)₁₀H.

Further embodiments within the scope of the invention are stable liquidcompositions consisting of essentially one or more omega-3 fatty acidsor derivatives thereof dissolved or dispersed in a liquidsemifluorinated alkane of formula F(CF₂)_(n)(CH₂)_(m)H or of formulaF(CF₂)_(n)(CH₂)_(m)(CF₂)_(o)F, wherein n, m, and o are integersindependently selected from the range of 3 to 20 and wherein the liquidvehicle is substantially free of water. Compositions comprising nofurther active compounds other than omega-3 fatty acid or derivativesthereof are also within the scope of the invention. Preferred are stableliquid compositions consisting of one or more omega-3 fatty acidselected from α-linolenic acid, docosahexaenoic acid, oreicosapentaenoic acid and ester derivatives thereof, wherein the omega-3fatty acid or ester derivative thereof is dissolved or dispersed in asemifluorinated alkane of the invention, for instance, F(CF₂)₆(CH₂)₈H.In a further preferred embodiment, the liquid composition consistsessentially of docosahexaenoic acid and/or eicosahexaenoic acid or esterderivatives thereof dissolved in or dispersed in F(CF₂)₆(CH₂)₈H.

In a particular embodiment, liquid compositions comprising at least twoor more semifluorinated alkanes further comprise one or moreomega-3-fatty acid or omega-3-fatty acid derivative, and/or omega-6fatty acid or omega-6 fatty acid derivative.

Also contemplated are methods of stabilizing a retinoid selected fromretinol, retinoic acid, retinal, tretinoin, isotretinoin, andalitretinoin or derivatives thereof, or sirolimus, or a polyenecompound, or ciclopirox olamine, comprising the step of dissolving,dispersing or suspending said compounds in a liquid vehicle comprising asemifluorinated alkane of formula F(CF₂)_(n)(CH₂)_(m)H or of formulaF(CF₂)_(n)(CH₂)_(m)(CF₂)_(o)F, wherein n, m, and o are integersindependently selected from the range of 3 to 20 and wherein the liquidvehicle is substantially free of water. In another embodiment, method ofstabilising a retinoid selected from retinol, retinoic acid, retinal,tretinoin, isotretinoin, and alitretinoin or derivatives thereof, orsirolimus, comprises the step of dissolving, dispersing or suspendingsaid compounds in a liquid vehicle comprising a semifluorinated alkaneselected from F(CF₂)₄(CH₂)₅H, F(CF₂)₄(CH₂)₆H, F(CF₂)₄(CH₂)₈H,F(CF₂)₆(CH₂)₄H, F(CF₂)₆(CH₂)₆H, F(CF₂)₆(CH₂)₈H, and F(CF₂)₆(CH₂)₁₀H.

In a further embodiment of the invention, liquid compositions comprisingat least two or more semifluorinated alkanes further comprise at leastone solubilized lipophilic vitamin or vitamin derivative.

The liquid compositions comprising an active compound with more than onealiphatic double bond prone to oxidation dissolved, dispersed orsuspended in a liquid vehicle comprising a semifluorinated alkane asdescribed previously, wherein the liquid vehicle is substantially freeof water may comprise at least about 0.01-10 wt. % of active compound.Preferably, the compositions comprise at least about 1 wt. % of activecompound relative to the weight of the composition, such as about 2 wt %or more, or at least 5 wt %.

The compositions of the present invention are useful as medicaments, inparticular as medicaments topically administered to an eye or ophthalmictissue, to the skin, or to the buccal, anal, vaginal, or nasal mucosa.

The SFA component of the liquid vehicle of these compositions exhibitproperties rendering them particularly amenable for ophthalmicapplications. Many of the SFAs as defined herein have refractive indicesclose to water. In one of the specific embodiments, the invention istherefore practised with an SFA whose refractive index is from 1.29 to1.35, and in particular from about 1.30 to about 1.35 at 20° C.

Moreover, SFAs according to the invention exhibit a remarkable wettingand spreading behaviour by which they can rapidly and effectively spreadover the corneal surface and conjunctiva. Wetting means the ability of aliquid to establish and maintain contact with a solid surface, resultingfrom intermolecular interactions when the two are brought together. Thebalance between adhesive and cohesive forces determines the degree ofwetting. The higher the adhesive forces compared to the cohesive forces,the more a drop of liquid will spread across the surface of the solidmaterial. Conversely, very high cohesive forces within the liquid willcause the drop to form a sphere, thus avoiding contact with the surface.Similarly, spreading may also occur at the interface of two liquidswhich are brought into contact with each other.

A measure for wetting and spreading is the contact angle θ. The contactangle is the angle at which the liquid-vapour interface meets thesolid-liquid or liquid-liquid interface. The tendency of a drop tospread out increases as the contact angle decreases. Thus, the contactangle provides an inverse measure of wettability.

A low contact angle of less than 90° indicates high wettability and/orspreading, whereas a higher contact angle indicates poor wettability andspreading. Perfect wetting and spreading results in a contact angle of0°, also reported as no measurable contact angle.

SFAs according to the invention exhibit excellent wetting of varioussurfaces. For example, the contact angle of both F4H5 and F6H8 ontablets compressed from either trospium chloride or fenofibrate (150 mgof drug substance compressed at 15-20 kN to tablets of 13 mm indiameter) is not measurable, i.e. there is perfect wetting. It is notedthat fenofibrate is an example of a hydrophobic, poorly water-solublecompound, whereas trospium chloride is hydrophilic and water-soluble.For comparison, the contact angle of purified water on the fenofibratetablet was determined as 92.5°, i.e. the tablet was poorly wetted bywater.

In addition, SFAs according to the invention are also capable of formingvery small droplets when dispensed from a dropper such as an eyedropper. Without wishing to be bound by theory, it is believed that thesmall droplet size is a result of an interplay of the SFA's uniqueproperties in terms of their density, viscosity, and surface tension. Inany case, it is believed that for topical administration into an eye asmall drop or volume of administration is highly advantageous as thecapability of the lacrimal sac to accept and hold fluid is extremelylimited. In fact, it is very common that the administration of aconventional eye drop formulation based on water or oil immediatelyleads to a discharge of a substantial fraction of the administeredmedicine as well as some tear fluid. At the same time, there is a riskthat some of the administered dose will be taken up systemically via thenasolacrimal duct.

The invention also provides a means of formulating non-aqueousophthalmic compositions which are microbiologically stable. Aqueousophthalmic compositions are prone to bacterial contamination. Incomparison, SFAs according to the invention have bacteriostaticproperties and do not support microbial growth. Hence, it is possible toformulate preservative-free ophthalmic compositions which are bettertolerable for many patients suffering from eye conditions that arereadily exacerbated by preservatives or other excipients that mayirritated through repeated exposure.

The compositions of the invention are thus very well suited for thetopical administration to an eye or ophthalmic tissue. Ophthalmic tissueincludes any surface of the eye anatomy that is, or can be (i.e. bynon-surgical means) topically exposed. Preferably, the compositions areadministered to the cornea or conjunctiva. The compositions are alsopreferably administered to the upper or lower eye lid margins, meibomiangland ducts, eyelashes or any area of the eye or eye lid anatomy.

In particular, it is contemplated that these compositions can be usedfor the treatment of a condition or disease of an eye or ophthalmictissue, such as inflammatory conditions of the ophthalmic tissue orkeratoconjunctivitis sicca (dry eye) or symptoms or conditionsassociated therewith. According to an embodiment of the invention, acomposition consisting of a semifluorinated alkane of the formulaF(CF₂)_(n)(CH₂)_(m)H, wherein n is an integer from the range of 3 to 8and m is an integer from the range of 3 to 10, and optionally one ormore further excipients may be used as a medicine in the treatment ofkeratoconjunctivitis sicca (dry eye) or a symptom or conditionassociated therewith

Keratoconjunctivitis sicca is a complex, multifaceted disease orcondition as described above. Aqueous-deficient DED, evaporative DED arewithin the scope of keratoconjunctivitis sicca and form specificsubtypes thereof. Sjögren syndrome, lacrimal gland insufficiency,meibomian gland disease and meibomian gland dysfunction, and otherconditions are also associated with keratoconjunctivitis sicca, beingdirect or indirect causes thereof, and may be treated with thecomposition of the invention.

Meibomian gland diseases cover a broad range of meibomian glanddisorders including neoplasia and congenital disorders. Meibomian glanddysfunction, on the other hand is understood to be abnormalities of themeibomian glands which are often characterized by gland ductobstructions and/or changes (qualitative and/or quantitative) to thesecretions of the glands. In general, conditions or disease statescausing or leading to an abnormal, reduced or increased delivery oflipids to the tear film can give rise to keratoconjunctivitis sicca andthe symptoms associated therewith.

Symptoms of keratoconjunctivitis sicca include a dry, scratchy, gritty,or sandy feeling in the eye; foreign body sensation; pain or soreness;stinging or burning; itching; increased blinking; eye fatigue;photophobia; blurry vision; redness; mucus discharge; contact lensintolerance; excessive reflex tearing. In addition to the symptoms ofkeratoconjunctivitis sicca as described, patients with meibomian glanddysfunction may also experience symptoms including itchiness, redness,swelling, pain or soreness, discharge accumulation or crustingspecifically at the lid margins. It is understood that not all patientssuffering from keratoconjunctivitis sicca exhibit all symptomssimultaneously. Hence, there is currently no uniform set of criteria fordiagnosing the disease. It is also understood that patients may sufferfrom one or more subtypes of keratoconjunctivitis sicca, or one or moreconditions or disease pathways causing keratoconjunctivitis sicca. It ishowever important to note that, within the scope of the presentinvention, any of the aspects, symptoms or pathophysiologicalconsequences of dry eye disease may be addressed.

The compositions of the invention may also comprise one or more activecompounds and/or further excipients as are required or useful. In anembodiment, the compositions of the invention may further comprise ananti-inflammatory compound selected from the group of NSAIDs,corticosteroids, and immunomodulators. In particular, such compositionsmay be useful as a medicament for topical administration to an eye orophthalmic tissue, especially as medicaments for treatment ofinflammatory conditions of ophthalmic tissue or keratoconjunctivitissicca (dry eye), or a symptom or condition associated therewith.Preferred immunomodulators are calcineurin inhibitors (e.g. cyclosporinor tacrolimus) or mTOR inhibitors (e.g. sirolimus). Preferred NSAIDSinclude flurbiprofen, diclofenac, indometacin, bromfenac, nepafenac,ketoprofen, and ketorolac and salts and derivatives thereof. Preferredcorticosteroids include prednisolone, loteprednol, dexamethasone,hydrocortison, rimexolone, fluorometholone and salts and derivativesthereof. These further active compounds are preferably also dissolved ordispersed in a liquid semifluorinated alkane of the invention.

In another embodiment, the compositions of the invention may alsofurther comprise one or more flavan-3-ols such as catechins. Catechin orcatechin isomers (e.g. epicatechin) and derivatives (for example, esterderivatives of catechin) are particularly preferred.

In terms of further excipients, if any, especially preferred are thosethat are biocompatible and are tolerated by the eye, and which areliquid and/or soluble and miscible in SFAs In particular, excipients arepreferably selected from lipids, oils, lubricants, lipophilic vitamins,viscosity agents, antioxidants, surfactants and mixtures of two or morethereof.

Examples of potentially useful lipids and oily excipients and which maybe included in the compositions of the invention include triglycerideoils (e.g. soybean oil, olive oil, sesame oil, cotton seed oil, castoroil, sweet almond oil), mineral oil (e.g. petrolatum and liquidparaffin), medium chain triglycerides (MCT), oily fatty acids, isopropylmyristate, oily fatty alcohols, esters of sorbitol and fatty acids, oilysucrose esters, oily cholesterol esters, oily wax esters,glycerophospholipids, sphingolipids, or any oily substance which isphysiologically tolerated by the eye. Any synthetic, semi-synthetic ornatural oily excipients which mimic or are structurally analogous orrelated to the components naturally found in the tear film lipid layerare also within the scope of the invention.

Examples of potentially useful lipophilic vitamin excipients includevitamin E (e.g. α-tocopherol) and their derivatives (e.g. tocotrienols)and esters (e.g. tocopherol acetate or tocopherol TPGS). In anembodiment, liquid compositions of the invention may further comprise atleast one lipophilic vitamin excipient that is completely solubilized.

Examples of potentially useful lubricants and/or viscosity agentsinclude carboxymethyl cellulose, hydroxymethyl cellulose, hydroxypropylcellulose, glycerol, polyvinyl alcohol, polyethylene glycol, propyleneglycol, hyaluronic acid, hydroxypropyl guar.

In one of the embodiments, the composition of the invention is free ofsurfactants. In an alternative embodiment, and depending on the specificactive ingredient to be formulated, a small amount of a physiologicallyacceptable surfactant may be incorporated. Potentially useful surfactantexcipients include in particular non-ionic surfactants or amphiphiliclipids. Surfactants which are considered potentially useful includetyloxapol, poloxamers such as Pluronic F68LF or Lutrol F68, PluronicL-G2LF and Pluronic L62D, polysorbates such as polysorbate 20 andpolysorbate 80, polyoxyethylene castor oil derivatives, sorbitan esters,polyoxyl stearates, and mixtures of two or more thereof.

The composition may of course comprise further excipients as required oruseful such as acids, bases, electrolytes, buffers, solutes,stabilisers, synergists, and—if required in a particular case—apreservative. In one of the embodiments, however, the composition isfree of preservatives.

The compositions may be formulated to be administered as a liquidsolution, gel, suspension, or spray. They may be prepared by commonlyknown techniques for the manufacture of said liquid solutions, gels,suspensions, or sprays.

Furthermore, the invention provides a pharmaceutical kit comprising thecomposition as described above and a container holding the composition.Preferably, the container which contains the composition has adispensing means such as a dropping device adapted for topicallyadministering the composition to the eye of a patient.

The following examples serve to illustrate the invention; however, theseare not to be understood as restricting the scope of the invention.

EXAMPLES Example 1

Solutions of the omega-3 fatty acid esters, eicosapentaenoic acid ethylester (EPA-EE) and docosahexenoic acid ethyl ester (DHA-EE), wereprepared in F(CF₂)₆(CH₂)₈H at concentrations of 1.0 wt % and 5.0 wt %.

Solutions containing a mixture of 1 wt % each of DHA-EE and EPA-EE(total 2.0 wt % of active compound) and 5.0 wt % of a combination of theDHA-EE and EPA-EE, at a ratio of approx. 2:3 in F(CF₂)₆(CH₂)₈H were alsoprepared. The solutions were filled in crimped vials and stored at 2-8°C., at 25° C./60% RH, and at 40° C./75% RH for the purpose of conductinga 6 month stability programme. The results obtained after a 13-weekperiod are reported herein.

Samples were taken from the vials at intervals for GC analysis (SeeTables 1-3 for result) of the compositions. The remaining percentages ofother components detected by GC (FID) but not shown here in the tablesare attributed to impurities already present in the original samples ofomega-3 fatty ester or the SFA vehicle before formulation. No rise inthe level of impurities was observed over the course of the stabilityprogram.

No significant observable changes in the content of the omega-3 fattyacid esters were detected under all temperatures tested. Results weremore or less also comparable across different batches at all storageconditions. In the following tables, the content of the activeingredient is presented as percentage relative to the initial content.

TABLE 1 Content of active compound (%) after storage at 2-8° C. CompoundAfter 4 weeks 1.0 wt % EPA-EE 99.6 1.0 wt % DHA-EE 99.5 5.0 wt % EPA-EE99.9 5.0 wt % DHA-EE 101.5 2.0 wt % EPA-EE/DHA-EE 100.2/99.7 5.0 wt %EPA-EE/DHA-EE 100.3/99.5

TABLE 2 Content of active compound (%) after storage at: 25° C./60% RHCompound After 4 weeks After 13 weeks 1.0 wt % EPA-EE 99.6 99.0 1.0 wt %DHA-EE 99.6 99.4 5.0 wt % EPA-EE 99.8 99.5 5.0 wt % DHA-EE 99.8 103.2¹2.0 wt % EPA-EE/DHA-EE 100.2/99.6 100.5/98.6 5.0 wt % EPA-EE/DHA-EE101.1/98.0 103.5/92.6 ¹Slight increase probably due to impurities withelution times similar to DHA-EE

TABLE 3 Content of active compound (%) after storage at 40° C./75% RHCompound 1 week 2 weeks 4 weeks 8 weeks 13 weeks 1.0 wt % EPA-EE 99.699.6 99.6 99.4 97.3 1.0 wt % DHA-EE 99.9 99.8 99.8 99.6 99.1 5.0 wt %EPA-EE 99.9 99.9 99.8 99.4 98.7 5.0 wt % DHA-EE 99.9 100.0 100.0 99.9100.0 2.0 wt % 101.8/ 100.3/ 100.5/ 100.8/ 100.8/ EPA-EE/DHA-EE 98.299.6 99.0 98.3 98.2 5.0 wt % 100.9/ 101.0/ 101.6/ 103.1/ 105.4/EPA-EE/DHA-EE 98.3 98.0 96.6 93.1 88.4

The invention claimed is:
 1. A method of treating a disease or conditionof a patient in need of such treatment, comprising administering aneffective amount of a stable liquid composition, wherein the compositionconsists of a semifluorinated alkane of the formulaF(CF₂)_(n)(CH₂)_(m)H, wherein n is an integer from 3 to 8 and m is aninteger from 3 to 10, and optionally one or more excipients, wherein thecomposition is topically administered to an eye or ophthalmic tissue ofthe patient, and wherein the disease or condition is an inflammatorycondition of the ophthalmic tissue or keratoconjunctivitis sicca (dryeye) and symptoms or conditions associated therewith.
 2. The methodaccording to claim 1, wherein the one or more excipient is selected fromthe group consisting of a lipid, oil, lubricant, lipophilic vitamin,viscosity agent, antioxidant, surfactant and mixtures of two or morethereof.
 3. The method according to claim 1, wherein the semifluorinatedalkane is a liquid selected from the group consisting of F(CF₂)₄(CH₂)₅H,F(CF₂)₄(CH₂)₆H, F(CF₂)₄(CH₂)₈H, F(CF₂)₆(CH₂)₄H, F(CF₂)₆(CH₂)₆H,F(CF₂)₆(CH₂)₈H, and F(CF₂)₆(CH₂)₁₀H.
 4. The method according to claim 1,wherein the symptom associated with keratoconjunctivitis sicca isselected from one or more of dry, scratchy, gritty, or sandy feeling inthe eye; foreign body sensation; pain or soreness; stinging or burning;itching; increased blinking; eye fatigue; photophobia; blurry vision;redness; mucus discharge; contact lens intolerance; and excessive reflextearing.
 5. The method according to claim 1, wherein the methodcomprises administering the composition to the cornea or conjunctiva, orthe upper or lower eye lid margins, meibomian gland ducts, or eyelashes.6. The method according to claim 1, wherein the composition is free ofwater and free of a preservative.
 7. The method according to claim 1,wherein the condition associated with keratoconjunctivitis sicca isselected from the group consisting of aqueous-deficient dry eye disease,evaporative dry eye disease, Sjögren syndrome, lacrimal glandinsufficiency, meibomian gland disease and meibomian gland dysfunction.8. The method according to claim 7, wherein the condition associatedwith keratoconjunctivitis sicca is meibomian gland dysfunction based onabnormalities of the meibomian glands characterized by gland ductobstructions and/or changes to the secretions of the glands.
 9. Themethod according to claim 7, wherein the condition associated withkeratoconjunctivitis sicca is meibomian gland dysfunction characterizedby a symptom selected from one or more of itchiness, redness, swelling,pain or soreness, discharge accumulation or crusting at the lid margins.